Vaccines are an important way for everyone to stay healthy. They decrease the risk of getting sick, and if you do get sick the illness will be less severe. Vaccines for people with diabetes (type 1 and type 2) are especially important, since their immune systems do not work as well, even if their diabetes is under control. People with diabetes are also more likely to develop complications – including long-term illness, hospitalization and even death – from certain vaccine-preventable diseases.
A recent Health Canada study showed that while most adults believed they had received all vaccines required for someone their age, less than 10% had actually received all of their recommended immunizations.
To stay healthy, it is important to review the vaccines mentioned below with your healthcare team to ensure that you’re up to date.
Pneumococcal vaccine (the pneumonia vaccine)
Pneumococcal vaccines help prevent serious infections caused by Streptococcus pneumoniae, including community-acquired pneumonia and invasive pneumococcal disease (IPD), which can lead to hospitalization, sepsis, and death.
In Canada, one dose of either Pneu-C-20 (Prevnar 20™) or Pneu-C-21 (Capvaxive™) is recommended for all adults aged 65 and older, and for adults under 65 who are at increased risk of IPD — including those with chronic conditions such as diabetes.
These newer conjugate vaccines offer longer-lasting protection and cover more strains than older formulations.
Across Canada, adults aged 18 to 64 who are at increased risk of invasive pneumococcal disease (IPD) are eligible for publicly funded pneumococcal vaccination. This typically includes one dose of Pneu-C-20 (Prevnar 20™) or Pneu-C-21 (Capvaxive™), regardless of prior vaccination history.
If you’ve previously received an older pneumococcal vaccine (such as PCV-13, PCV-15, or PPSV-23), you should wait at least one year before receiving one of the newer vaccines.
Influenza immunization (the flu shot)
Influenza is not just a cold — it can lead to serious illness, hospitalization, and even death. Getting vaccinated each year is the best way to protect yourself and others, as the flu shot helps guard against multiple circulating flu viruses.
In Canada, the flu vaccine is typically available starting in October at your doctor’s office, local pharmacy, or public health clinic.
Most people can safely receive the flu shot. The only exceptions are those with a severe allergy to a vaccine ingredient (such as egg protein, though most flu vaccines are now considered safe for people with egg allergies), those who currently have a fever, or those who’ve had a serious reaction to a previous flu vaccine. For everyone else, the flu shot is generally safe, and serious reactions are very rare.
For older adults, the National Advisory Committee on Immunization (NACI) strongly recommends enhanced flu vaccines when available. These include high-dose, adjuvanted, or recombinant options, which offer stronger protection compared to the standard-dose vaccine.
This year, Canada is using a trivalent flu vaccine instead of the quadrivalent version, due to the global disappearance of the B/Yamagata strain. The trivalent vaccine still provides effective protection against the most common strains expected to circulate.
COVID-19 vaccine updates
Anyone can be infected with SARS-CoV-2 (COVID-19), but some people are at higher risk of exposure or severe illness. This includes older adults (65+), individuals with certain medical conditions such as type 1 or type 2 diabetes, and those living or working in high-risk settings. People who are pregnant, members of First Nations, Métis, and Inuit communities, racialized and equity-deserving groups, and essential service providers are also considered at increased risk.
Unlike influenza, COVID-19 circulates year-round, although activity tends to rise from late summer through early January. Vaccination remains a key tool to reduce the risk of infection and severe outcomes.
For most adults, the minimum interval between COVID-19 vaccine doses is three months after a previous dose or infection. Timing should also consider factors like community transmission, upcoming travel, surgery, or large gatherings.
Receiving an updated dose is important because it boosts immunity that may have waned over time and provides better protection against currently circulating strains. The updated mRNA vaccines from Moderna and Pfizer are considered interchangeable, provided age eligibility is met. This year, the targeted strain in Canada is LP.8.1, part of the JN.1 lineage of Omicron variants, which reflects the most prevalent circulating virus.
Respiratory Syncytial Virus (RSV)
RSV is a common but highly contagious virus that usually causes mild, cold-like symptoms. However, in vulnerable populations — including older adults and those with chronic health conditions — RSV can lead to serious complications such as bronchiolitis, pneumonia, hospitalization, and even death. It can also worsen conditions like COPD, asthma, diabetes, and congestive heart failure.
Health Canada has approved three RSV vaccines for adults: Arexvy®, Abrysvo® and mRESVIA®.
As of November 2024, Arexvy® is authorized for use in adults aged 50 to 59 who are at increased risk of RSV-related complications. This includes individuals with chronic conditions such as diabetes, asthma, COPD, and heart failure. The vaccine is administered as a single dose, and current evidence shows protection lasting at least two RSV seasons.
The NACI recommends that adults aged 50 to 74 may consider RSV vaccination in consultation with their healthcare provider, especially if they have underlying medical conditions.
Hepatitis B vaccine
This immunization protects against liver infection due to the hepatitis B virus. This virus is usually spread when blood or other body fluids from a person infected with the hepatitis B virus enter the body of someone who is not infected. People living with diabetes are at increased risk for hepatitis B if they share blood glucose meters, lancets or other diabetes care equipment such as syringes or insulin.
The hepatitis B virus can survive outside the body for at least a week and, during that time, can cause infection if it enters the body of a person who is not infected. In fact, transmission has occurred among people with diabetes who reside in assisted-living facilities when several people received glucose monitoring in close succession. The hepatitis B vaccine is given as a series of three shots over a six-month period, and the entire series is needed for long-term protection.
Herpes zoster (shingles vaccine)
Shingles is a painful skin rash that can occur anywhere on the body. A shingles infection can be very serious (especially in older people) and can lead to such complications as loss of vision and debilitating nerve pain. It is caused by the varicella zoster virus, which is the same virus that causes chickenpox. You can get shingles at any age, even if you have had chickenpox. However, age is the most important risk factor for shingles. Two-thirds of shingles cases in Canada happen to people who are over 50 years old, and the severity of shingles and its complications also increases with age.
The shingles vaccine, Shingrix®, is a recombinant, non-live vaccine that is highly effective. It reduces the risk of shingles by 97% in adults aged 50–69, and by 90% in those aged 70 and older. It also helps reduce the intensity and duration of nerve pain if shingles does occur.
Shingrix® is publicly funded in Ontario for adults aged 65–70, and in several other provinces with varying eligibility. Nova Scotia offers it free to all adults 65+, while Québec covers those 75+ and immunocompromised individuals. Newfoundland and Labrador is expanding coverage to all adults 50+ starting September 2025. In other provinces, Shingrix may be available by prescription and covered through private insurance or paid out-of-pocket.
Shingrix is also recommended for:
- All adults aged 50 and older, regardless of prior shingles history
- Adults 18 and older who are immunocompromised, including those undergoing immunosuppressive therapy
There is no current recommendation for booster doses, and individuals should wait at least one year after a shingles episode or after receiving Zostavax before starting the Shingrix series.
Booster for tetanus/diphtheria/pertussis
This is part of the series of the many routine vaccines administered as part of the childhood vaccination schedule in Ontario. Tdap is a combination vaccine that protects against three potentially life-threatening bacterial diseases: tetanus, diphtheria, and pertussis (whooping cough). Adults between 19 and 64 years of age should receive a booster dose (second shot) every 10 years for continued immunity. Check with your doctor to see whether your booster shots are up to date.
Vaccines prior to travel
If you will be visiting other countries, you could be exposed to diseases (e.g. yellow fever, rabies, Japanese encephalitis) that are not frequently seen in Canada. Some of these may be caused by contaminated food or water, human contact, insect bites or other means. It is always advisable to visit a designated travel clinic prior to travelling abroad to determine if additional vaccines are required.
Vaccine use may differ depending on where you live, your age, medical history and other factors.
Talk to your healthcare provider about what vaccines are recommended for you.
